Organization
INTERNAL MEDICINE &PSYCHIATRIC SERVICES OF THE PIEDMONT
Active
Other names
IMPSP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA P KILLIAN (PRACTICE MANAGER)
(828) 325-0555
Entity
Organization
Contact information
Practice address
929 15TH ST NE, SUITE 100, HICKORY, NC 28601-4161
(828) 325-0555
(828) 267-7555
Mailing address
PO BOX 1447, HICKORY, NC 28603-1447
(828) 325-0555
(828) 267-7555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200501179
NC
2084P0800X
Psychiatry Physician
200501179
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022MM
BCBS
NC
01
—
513278
MANAGED HEALTH NETWORK
NC
05
—
5913662
—
NC
01
—
DQ4195
RAILROAD MEDICARE
NC
Enumeration date
09/03/2009
Last updated
06/25/2015
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